[1]颜维华,谭华伟,张培林,等.日本诊断群分类支付制度改革经验及启示[J].卫生经济研究,2019,(03):39-43.
　YAN Wei-hua,TAN Hua-wei,ZHANG Pei-lin,et al.Japanese Diagnostic Group Classification Payment System Reform Experience and Enlightenment[J].Journal Press of Health Economics Research,2019,(03):39-43.
点击复制

日本诊断群分类支付制度改革经验及启示
分享到：

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2019年03期
页码:
39-43
栏目:
他山之石
出版日期:
2019-02-28

文章信息/Info

Title:
Japanese Diagnostic Group Classification Payment System Reform Experience and Enlightenment
作者:
颜维华1; 2; 谭华伟1; 2; 张培林1; 2; 刘 宪1; 2; 程 伟1; 2; 郑万会1; 2; 陈 菲3; 于 雪3; 张荣娜3
1.重庆市医院成本管理研究中心， 重庆 400700
2.重庆市第九人民医院， 重庆 400700
3.重庆医科大学公共卫生与管理学院， 重庆 400016
Author(s):
YAN Wei-hua; TAN Hua-wei; ZHANG Pei-lin; LIU Xian; CHENG Wei;  ZHENG Wan-hui; CHEN Fei; YU Xue;  ZHANG Rong-na
Chongqing Hospital Cost Management Research Center，Chongqing 400700，China
关键词:
诊断群分类支付制度; 按病种付费; 支付方式改革; 日本
Keywords:
diagnostic group classification payment system; payment by disease type;  payment method reform; Japan
分类号:
R19
文献标志码:
A
摘要:
按病种付费是我国支付制度改革的重点。借鉴日本诊断群分类支付制度改革经验，提出完善我国按病种付费制度的政策路径：厘清病种支付制度改革逻辑，适度整合DRG和病种（组）分值支付优点，有效衔接医师费和医院费、供方和需方两对关系，将弹性支付机制作为调节阀，完善医保信息系统智能化建设。
Abstract:
Paying by disease is the focus of China's payment system reform. Drawing on the experience of the Japanese diagnostic group classification payment system reform，this paper proposed a policy path to improve the disease-based payment system in China：clarifying the logic of the reform of the disease payment system，moderately integrating the advantages of DRG and disease group， and effectively linking physician fees and hospitals. The relationship between fee， supplier and demander will be used as a regulating valve to improve the intelligent construction of medical insurance information system.

参考文献/References:

[1] Shinichi O,Ryota K, Tetsuo S.Case-mix payment in Japanese medical care[J].Health Policy,2005(74):282-286.
[2] Yoshiaki N ,Tadamasa T,Hiroyuki Y,et al.A New Accounting System for Financial Balance Based on Personnel Cost After the Introduction of a DPC/DRG System[J].Journal of medical systems,2011(35):251-264.
[3] Ishii M.DRG/PPS and DPC/PDPS as Prospective Payment Systems[J].JMAJ,2012,55(4): 279-291.
[4] Etsuji O, Toshiro K.Estimation of per-case hospitalization charges from Diagnosis-Procedure-Combination data and an international comparison of hospital prices[J].Journal of the National Institute of Public Health,2014,63(6):532-537.
[5] 谭华伟,张培林,姚旭,等.公立医院医疗项目作业成本核算方法实践研究[J].卫生经济研究，2018（10）：41－46.
[6] 颜维华，谭华伟,张培林,等.我国公立医院内部绩效管理的RBRVS实践[J].卫生经济研究，2018（12）：47－51，54.
[7] 贾洪波,段文琦.基本医保按病种分值付费的实践探索[J].卫生经济研究，2018(5):57-59.
[8] 仇雨临.医保与三医联动:纽带、杠杆和调控阀[J].探索,2017(5):65-71.

相似文献/References:

[1]尹红燕,王 珩,李念念,等.以历史费用为基础的单病种定额标准测算研究[J].卫生经济研究,2017,(03):53.
[2]胡文杰,刘 明,徐俊英,等.医院病种成本核算的实践及探索[J].卫生经济研究,2018,(07):54.
[3]于保荣.按病例支付及医疗服务支付方式改革的实现条件——从DRGs、按病种付费、点数法付费及临床路径谈起[J].卫生经济研究,2018,(09):16.
　YU Bao-rong.Conditions for the Implementation of Reforms by Case Payment and Payment for Medical Services ——From DRGs，Case-based payments，Point payments，and Clinical pathways[J].Journal Press of Health Economics Research,2018,(03):16.
[4]朱 坤.县级公立医院按病种付费实施现状与建议 ——基于项目省的实践[J].卫生经济研究,2019,(03):5.
　ZHU Kun.Current Status and Recommendations for County-level Public Hospitals to Pay for Diseases——Based on the Practice of the Project Province[J].Journal Press of Health Economics Research,2019,(03):5.
[5]张文娟,宋厚斌,王新虹,等.基于临床路径的按病种付费分段控制标准化构建[J].卫生经济研究,2019,(07):36.
　ZHANG Wen-juan,SONG Hou-bin,WANG Xin-hong,et al.Standardized Construction of Disease-based Segmentation Control Based on Clinical Path[J].Journal Press of Health Economics Research,2019,(03):36.
[6]朱 先,向 前.基于RBRVS与DRGs视角的按病种付费模式探讨[J].卫生经济研究,2020,(01):32.
　ZHU Xian,XIANG Qian.Discussion on the Disease-based Payment Model based on the Perspective of RBRVS and DRGs[J].Journal Press of Health Economics Research,2020,(03):32.
[7]李 芬,金春林,朱莉萍,等.以价值为导向的医保支付制度实施路径[J].卫生经济研究,2021,38(1):10.
　LI Fen,JIN Chun-lin,ZHU Li-ping,et al.The Implementation Path of Value-oriented Medical Insurance Payment System[J].Journal Press of Health Economics Research,2021,38(03):10.
[8]杨 菁,李梦滢,沈际勇.中医优势病种支付方式改革试点经验与启示[J].卫生经济研究,2023,40(12):33.
　YANG Jing,LI Mengying,SHEN Jiyong.Experience and Enlightenment of the Pilot Reform of Payment Methods for Dominant Diseases of Traditional Chinese Medicine[J].Journal Press of Health Economics Research,2023,40(03):33.
[9]岳铭坤,李 凯,黄 娜,等.按病种付费对中医优势病种住院费用的影响研究 ——基于PSM-DID法[J].卫生经济研究,2024,41(03):62.
　YUE Mingkun,LI Kai,HUANG Na,et al.Study the Impact of DRG on the Hospitalization Expenses of the Dominant Diseases of Traditional Chinese Medicine ——Based on PSM-DID Method[J].Journal Press of Health Economics Research,2024,41(03):62.
[10]于 伟,李佳宁,钟 璐,等.中医优势病种按疗效价值付费改革效果分析[J].卫生经济研究,2025,42(04):23.
　YU Wei,LI Jianing,ZHONG Lu,et al.Analysis of the Effect of the Payment Reform according to the Value of Efficacy for Dominant Diseases in Traditional Chinese Medicine[J].Journal Press of Health Economics Research,2025,42(03):23.

更新日期/Last Update: 2019-02-28